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At least 19 recordsLinked to original sources
PubMed1994

[Thromboembolic disease in the puerperium (is thrombotic prophylaxis necessary in the puerperium)].

The author makes retrospectively investigation in 3064 young mothers about determination on dependence between thromboembolism and varices in early puerperium. He finds varices in 1.01% of cases from which 84% are without prophylaxis. In 42% of them with complaints are applied medicine. In 0.13% of cases in puerperium develops thrombophlebitis (0.08-1.35% in bibliography information). The author finds in 0.098% of cases pulmonary thromboembolism (0.04-0.05% in bibliography information). In 77% of them he find out birth traumatism. In conclusion the author recommends prophylaxis with Heparin in early puerperium by cases with previous thromboembolism, traumatic parturition and doubt for infection.

Adult↗
PubMed1976

[Function of thrombocytes during gestation and puerperium as well as their relations to thrombosis. 1. Function of blood platelets in normal pregnancy, during labor and puerperium].

Platelet functions during late pregnancy and puerperium were observed. It was found pregnancy variations of the number of platelets, platelet spreading, -aggregation, adhesiveness and thrombelastographic investigations. In this observations is not conclude from increase risk developing a thromboembolic disease during pregnancy and puerperium.

Blood Platelets↗
PubMed1980

[Control of puerperium in swine under conditions of extremely shortened nursing method. 1. Results of histological studies in postpartum involution and regeneration of the uterus under conditions of extremely shortened nursing period and medicamentous control of puerperium].

Uterus tissue samples were taken from 31 sows which had been under regimes of extremely shortened nursing periods and differentiated medication to control their puerperium. The samples were taken following laparotomy during the first postpartum oestrus as well as in subsequent phases of the cycle and histologically tested for puerperal involution and regeneration. The endometrium and myometrium of sows in oestrus were found to be in a condition which widely corresponded to normal oestrus condition of the uterus wall, when their piglets had been weaned in the third postpartum week. However, untreated sows in oestrus, whose piglets had been weaned extremely soon, that is in the second postpartum week, displayed numerous signs of inadequate postpartum involution and regeneration. Oxytocin was found to work well in speeding up regeneration of both the endometrium and myometrium. Intramuscular injection of twice nine International Units per die, from the first through ninth days postpartum, helped to complete largely all regeneration processes up to the first oestrus, when piglets had been weaned in the second postpartum week. Oral antibiotic medication (chlortetracycline) and parenteral application of vitamins failed to produce any substantive and histologically recordable effect on puerperal involution processes.

Animals↗
PubMed1976

[Function of thrombocytes during the gestational period and puerperium and their relation to the occurence of thromboses. 2. Function of blood platelets during late pregnancy, labor and puerperium in gestosis].

Platelet functions during late pregnancy with praeeclampsia, birth and childbed were observed. There are found variations in opposition to normal pregnancy. Increase of platelet aggregation was clearest. In this observations is not conclud from increase risk developing a thromboembolic disease during toxemic pregnancy, birth and childbed. The variations of platelet functions are parts of complex appearence.

Female↗
PubMed1976

[Changes in the blood picture during puerperium of Czech white-breed sows under large-scale breeding conditions].

A dynamics of the changes of the red and while blood cell count during puerperium (1st-27th day post partum) was studied in 293 sows of the Czech White breed kept in typical large-scale production conditions. An average count of erythrocytes amounted to 5 513 000 +/- 385 514. In the course of puerperium their count slightly decreased in comparison with the value obtained on the first day p. p. (on the 10th day p. p. the decrease was even highly statistically significant - P less than 0.01). An average amount of hemoglobin was 12.48 +/- 1.22 g per 100 ml of blood; in the course of the nearly whole of puerperium it was slightly higher than on the first day p. p. (in the third week on the threshold of the statistical significance up to the statistical significance - P less than 0.10-0.05-0.01). The value of hematocrit did not fluctuate (average = 38.65 +/- 3.89%), sedimentation slowed down, especially from the end of the second week p. p. The protein of the blood plasma amounted, on an average, to 7.71 +/- 0.84 g per 100 ml; the protein content raised during puerperium in comparison to the 1st day .p. An average count of leukocytes during puerperium was in comparison to the 1st day p.p. An average count of leukocytes during puerperium 12 755 +/- 1529, and it slightly increased in relation to the 1st day p. p. The percentage of neutrophile granulocytes and lymphocytes did not change very much; it reached 46%: 45%. The character of the sow blood during puerperium fluctuated all the time between neutrophile and lymphocytic type with a slight tendency to the prevalence of neutrophile granulocytes. Nevertheless, the proportion of neutrophile granulocytes with rodlike nuclei decreased, and on the other hand, the proportion of neutrophile granulocytes with segmented nuclei increased (a nucleus shift to the right). Original values and ratio of the first day p. p. (T = 6.91%: Seg = 41.13%) changed in the average value of T = 1.93%: Seg = 43.96% during the whole puerperium.

Animal Husbandry↗
PubMed2002

Depressive and anxiety symptoms in the early puerperium are related to increased degradation of tryptophan into kynurenine, a phenomenon which is related to immune activation.

There is now some evidence that i) the availability of plasma tryptophan, the precursor of serotonin, is significantly lower in pregnant women at the end of term and the first few days after delivery than in nonpregnant women; and ii) both pregnancy and the early puerperium are accompanied by activation of the inflammatory response system. The aims of the present study were to examine the effects of pregnancy and delivery on plasma kynurenine, a major tryptophan catabolite synthesized after induction of indoleamine-2, 3 dioxygenase (IDO) by pro-inflammatory cytokines. We measured plasma kynurenine and tryptophan and immune markers, such as serum interleukin-6 (IL-6), IL-8 and the leukemia inhibitory factor-receptor (LIF-R) in healthy, nonpregnant and pregnant women at the end of term and one and three days after delivery. Plasma kynurenine was significantly lower in pregnant women at the end of term than in nonpregnant women, findings which may be attributed to lower plasma tryptophan at the end of term. The kynurenine/tryptophan (K/T) quotient was significantly higher in the pregnant women at the end of term and in the early puerperium than in nonpregnant women. In the early puerperium there was a significant increase in plasma kynurenine and the K/T quotient. The increases in plasma kynurenine and the K/T quotient were significantly more pronounced in women whose anxiety and depression scores significantly increased in the puerperium. The changes from the end of term to the early puerperium in plasma kynurenine and the K/T quotient were significantly related to those in the immune markers. It is concluded that 1) lower plasma kynurenine at the end of term is the consequence of lower plasma tryptophan; 2) the increased K/T quotient at the end of term and in the early puerperium indicates inflammation-induced degradation of tryptophan along the kynurenine pathway; and 3) that depressive and anxiety symptoms in the early puerperium are (causally) related to an increased catabolism of tryptophan into kynurenine, a phenomenon which probably results from immune activation.

Adult↗
PubMed1999

General health and psychological symptom status in pregnancy and the puerperium: what is normal?

OBJECTIVE: To identify normative changes in psychological and physiologic health status associated with pregnancy and the puerperium. METHODS: Self-administered surveys containing Ware's Short Form-36 and Derogatis's Brief Symptom Inventory were completed by 393 pregnant women during their third trimester. Of those, 253 completed the same survey during the puerperium. Results were compared between periods and with those of samples of women from standardized community samples. RESULTS: On the Short Form-36, pregnant women in the third trimester had significantly poorer levels of functioning (P<.01) than community controls with regard to bodily pain (51.86 versus 79.61), physical functioning (62.91 versus 89.12), social functioning (74.0 versus 84.06), vitality (47.24 versus 58.04), and functional limitations resulting from physical health problems (45.0 versus 86.73) subscales. Those differences persisted into the puerperium. Compared with pregnancy, scores on social functioning and functional limitations caused by emotional problems decreased during the puerperium. Women reported improved perceptions of their general health in the puerperium compared with community controls (80.22 versus 74.80). On the Brief Symptom Inventory, pregnant women reported significantly higher levels of emotional distress on the three global measures and on the somatization (0.75 versus 0.35), obsessive-compulsive (0.70 versus 0.48), and hostility (0.59 versus 0.36) subscales than controls; those changes normalized in the puerperium. CONCLUSION: Pregnancy and the puerperium are associated with significant changes in psychological and physiologic health status. Documentation of those changes is important if the Short Form-36 and Brief Symptom Inventory are to be used in health outcomes research with this population.

Adult↗
PubMed1996

Increased rate of lupus flare during pregnancy and the puerperium: a prospective study of 78 pregnancies.

The objective was to determine whether the frequency of flare in systemic lupus erythematosus (SLE), patients is increased during pregnancy and the puerperium. Seventy-eight pregnancies in 68 SLE patients attending the lupus pregnancy clinic, at St. Thomas' Hospital, during the last 5 yr were included. The pregnancy period and 8 weeks post-delivery were considered. This group was compared with a control group of 50 consecutive, non-pregnant, age-matched SLE patients attending our weekly lupus clinic. Additionally, 43 of the pregnant patients carried on attending the lupus clinic for the year after puerperium, and their course was compared with themselves during pregnancy. SLE activity was assessed using the Lupus Activity Index (LAI) score. An increase > or = 0.26 in the score was considered as a flare of the disease. Pregnancy and control groups were homogeneous for age, race, disease duration and distribution of autoantibodies. Sixty-five per cent of the patients flared during pregnancy and/or the puerperium and 42% flared in the control group (P = 0.015). The rates of flare per patients/month were 0.082 +/- 0.004 for the pregnancy group and 0.039 +/- 0.003 for the control group (P < 0.001). The 43 patients whose course was controlled after the puerperium flared more frequently during pregnancy that thereafter (McNemar test, P = 0.003). The rates of flare per patient/month were 0.093 +/- 0.006 during pregnancy and the puerperium, and 0.049 +/- 0.004 after the puerperium (P = 0.0015). Kidney and central nervous system involvement was not different between the pregnancy and control groups. In terms of frequency of flares, there was no difference in any of the groups between patients taking and not taking steroids. We conclude that SLE tends to flare during pregnancy. Flares are maximal during the second and third trimester and the puerperium. Flares are not more severe than in non-pregnant patients, and most of the flares can be managed conservatively. Prednisolone does not prevent flares.

Adult↗
PubMed2004

Incidence and etiologies of stroke during pregnancy and puerperium as evidenced in Taiwanese women.

BACKGROUND: Pregnancy is a known risk factor for stroke, but relatively few studies have been conducted in Asian populations to document the risk. This study aimed to analyze the incidence and etiologies of stroke occurring during pregnancy and puerperium in Taiwanese women. METHODS: From 1984 to 2002, female patients 15 through 40 years of age with first-ever stroke during pregnancy or within 6 weeks of delivery were recruited. Stroke was classified as ischemic stroke (IS), cerebral venous thrombosis (CVT), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH). The incidence, time of stroke onset (1st through 3rd trimester or puerperium), and etiologies of different stroke subtypes were analyzed. RESULTS: Of 402 young female stroke patients, 49 had stroke during pregnancy and puerperium, including 16 with IS, 11 with CVT, 19 with ICH and 3 with SAH. After excluding referral patients, the incidences of pregnancy-related stroke were 46.2 (95% CI 30.7-69.5) per 100,000 pregnancies. 67% developed stroke in the 3rd trimester and puerperium, and 73% of CVT occurred in the puerperium period. Etiologies were well defined in 78% of patients. Eclampsia (37%) and arteriovenous malformation (26%) were the most important etiologies of ICH. For IS and CVT, rheumatic heart disease (44%) and coagulopathy (64%) were the major etiologies respectively. CONCLUSIONS: The incidence of stroke occurrence during pregnancy and puerperium in Taiwanese women is higher than that of Caucasian populations; the majority of strokes occurred in the 3rd trimester and puerperium, particularly CVT.

Adult↗
PubMed1999

Evaluation of hepatic venous pulsatility and portal venous velocity with Doppler ultrasonography during the puerperium.

OBJECTIVE: The aim of this study is to evaluate pregnancy-induced changes of hepatic venous pulsatility and portal venous velocity in the puerperium and to determine if these changes disappeared by the end of the puerperium. METHODS AND MATERIAL: Healthy normal volunteers (90) were examined on the 2nd and 7th days of puerperium and between the 6th and 8th weeks postpartum. Doppler waveform patterns were obtained in the middle hepatic vein and main portal vein. The hepatic venous pulsatility was named as normal, damped or flat. RESULTS: On the 2nd day postpartum, the hepatic vein pulsatility was shown as normal in 8 (26%), damped in 11 (37%) and flat in 11 (37%) cases. On the 7th day postpartum, 15 (50%) cases had normal, 9 (30%) cases had dampened, and 6 (20%) cases had still flat pattern. The majority of the cases (60%) displayed normal hepatic venous pulsatility in the 6th and 8th weeks of puerperium, whereas 23% had still dampened and 17% had flat patterns. There was a trend toward normal pulsatility with increasing puerperal age. The mean portal venous velocity was still higher than the non-pregnant levels and did not showed significant alterations during puerperium. CONCLUSION: This study emphasised that, since pregnancy-induced alterations in hepatic venous pulsatility and portal venous velocity had not completely returned to normal in most cases until the end of the puerperium, these physiological changes should be considered whenever hepatic and portal systems are interpreted with Doppler sonography during the puerperal period.

Adult↗
PubMed1999

Deep vein thrombosis during pregnancy and the puerperium: a meta-analysis of the period of risk and the leg of presentation.

UNLABELLED: We performed a meta-analysis of all published studies of deep vein thrombosis during pregnancy and the puerperium using MEDLINE between 1966 and May 1998. Data were pooled using a random effects model. Fourteen studies included relevant information on deep vein thrombosis in pregnancy or the puerperium, and used objective testing to diagnose deep vein thrombosis. The pooled event rate for left sided or bilateral deep vein thrombosis was 82.2 percent (95 percent CI 75.1 to 87.5). There was no statistical evidence of heterogeneity for this figure (P = .08). Twelve studies reported on the trimester in which deep vein thrombosis was diagnosed. The deep vein thrombosis event rate during the first trimester was 21.9 percent (95 percent CI 17.4 to 27.3), 33.7 percent (95 percent CI 28.1 to 39.8) during the second trimester, and 47.6 percent (95 percent CI 39.2 to 56.2) for the third trimester. Heterogeneity testing was not significant. Nine studies compared deep vein thrombosis events between the antepartum and puerperium periods, with 65.5 percent (95 percent CI 58.1 to 72.1) arising during pregnancy, and 34.5 percent (95 percent CI 27.9 to 41.9) postpartum (P = .08, not heterogeneous). Using these figures, the estimated relative distribution of 100 deep vein thrombosis events during pregnancy and the puerperium would be 0.23 per day during pregnancy, and 0.82 per day in the postpartum period. During pregnancy and the puerperium, deep vein thrombosis is more likely to arise in the left leg. More than half of all deep vein thromboses during pregnancy occur during the first and second trimesters. Furthermore, during the puerperium, the risk of developing deep vein thrombosis is significantly higher than antepartum. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES: After completion of this article, the reader will be able to understand the incidence and distribution of DVTs during pregnancy and to be able to appreciate the differing risk of DVT during the various time periods in a pregnancy.

Female↗
PubMed2006

The risk of recurrent venous thromboembolism in pregnancy and puerperium without antithrombotic prophylaxis.

Whether or not pregnant women with a previous episode of venous thromboembolism (VTE) should receive antithrombotic prophylaxis is a matter of debate. In order to estimate the rate of recurrent deep venous thrombosis (DVT) or pulmonary embolism (PE) during pregnancy and puerperium we retrospectively investigated a cohort of 1104 women with previous VTE; after a single DVT or isolated PE, 88 of them became pregnant at least once without receiving antithrombotic prophylaxis. Overall, 155 pregnancies and 120 puerperium periods without prophylaxis were recorded. There were nine recurrences during pregnancy and 10 during puerperium, with a rate of 5.8% [95% confidence interval (CI) 3.0-10.6] and 8.3% (95%CI 4.5-14.6) respectively. In pregnancy, the rate of recurrence was 7.5% (95%CI 4.0-13.7) if the first VTE was unprovoked, related to pregnancy or to oral contraceptive use, whereas no recurrence occurred if the first VTE was related to other transient risk factors. In puerperium, the rate of recurrence was 15.5% (95%CI 7.7-28.7) in women with a pregnancy-related first VTE, with a risk 3.9-times higher than in the remaining women. Inherited thrombophilia was not associated with a statistically significant increase in risk of recurrence in pregnancy or in puerperium, yet the rate of recurrence in puerperium was 14.2% (95%CI 5.7-31.4) in overall carriers of factor V Leiden and 30% (95%CI 10.7-60.3) in carriers with a pregnancy-related first VTE, with a risk 6.8 times higher than in women without thrombophilia and with a non pregnancy-related first VTE.

Adult↗
PubMed1999

Stroke complicating pregnancy and the puerperium.

BACKGROUND: The role of nonobstetric factors, such as stroke, in maternal mortality has become of increasing importance because maternal deaths resulting directly from obstetric causes are decreasing. Strokes contribute to high mortality and morbidity, and are severe complications during pregnancy and puerperium. The objective of this study was to investigate the maternal outcome of patients with complications of stroke during pregnancy and puerperium. The causes, incidence and essential management of stroke are also reviewed. METHODS: During the 10-year period from January, 1986, to January, 1996, women who suffered from stroke during pregnancy, or up to six weeks postpartum, and were discharged from our hospital were identified. Stroke was defined as the abrupt onset of a focal neurologic syndrome that consisted of hemorrhagic and ischemic central nervous system events. All were assessed using computerized tomography or magnetic resonance imaging. Neurologists reviewed each case from the medical records. RESULTS: Thirteen women who had had a stroke during pregnancy or puerperium were identified. Nine of these women had intracerebral hemorrhage and four had ischemic strokes. During this 10-year period, approximately 85,321 women gave birth at the Mackay Memorial Hospital, and the incidence of stroke was approximately 1 in 6,500 pregnancies. Among the nine cases of hemorrhagic strokes, three women had preeclampsia and one had gestational diabetes mellitus. Mortality from strokes was 38%, and 63% of survivors had residual neurologic deficits; 46% of the strokes occurred during the puerperium. CONCLUSIONS: Stroke during pregnancy and puerperium causes high mortality and morbidity. Early diagnosis and adequate treatment cannot be overemphasized, as prompt and proper management is beneficial for outcome. The same meticulous care provided during the antepartum and intrapartum periods should be continued into the puerperium.

Adult↗
PubMed1999

[The management of cervical cancer cases in pregnancy and puerperium].

UNLABELLED: Cervical cancer in women during pregnancy and puerperium is a serious diagnostic and therapeutic problem. Twelve multiparas with confirmed cervical cancer during pregnancy, delivery and puerperium were examined. The mean age of the group was 35. In two of them cervical cancer was diagnosed in the second trimester, in 5 in the third trimester and in 5 in puerperium. Clinical stage according to FIGO was as follow: Ib--9 patients, IIa--2 patients, III--1 patient. In two patients operated in the second trimester--extended hysterectomy was performed. In four women cesarean section with extended hysterectomy and lymphadenectomy was performed. Only one patient in third trimester had cesarean section and in the same time unradical hysterectomy because of bleeding. In two patients in puerperium extended hysterectomy was performed (Meigs operation). Three patients underwent only radiotherapy. All patients who were operated on underwent subsequent radiotherapy. CONCLUSIONS: Cervical cancer during pregnancy and puerperium is diagnosed very late, usually in advanced stage. It is connected with lack of clinical and cytological examination of women before pregnancy. Principles of treatment of cervical cancer in pregnancy and puerperium do not differ from those applicable in other patients.

Adult↗